What are the challenges?

Whilst peer-based programs have many benefits, there are also significant challenges to implementing peer-based initiatives for young people.

There may also be a number of limitations to using a peer-based approach that should be considered when deciding which strategy to use.

Peer-based programs are not for everyone

Practitioners should recognise that peer-based programs are not suitable for every individual in the target population at which the service is aimed at. For example, a young person at risk of suicide is likely to require more treatment focused and professional help, while catering to their needs would exceed the responsibility of a young person in the role of a peer supporter.

Other reasons may include:

accessibility, stage of maturity and social confidence (i.e. fear of group settings) of the young person;
a young person with existing or developing mental health issues;
having access to other sources of social support and friendships; or
a preference for anonymity (which may be afforded by online support).

It is important to recognise that most peer-based initiatives are positioned as preventative strategies and provide social support, i.e. they may help mental health problems from developing and/or may identify referral pathways.¹ Peer-based initiatives are not suitable for treating existing mental health problems; where counselling or therapeutic intervention is more appropriate.² There are circumstances where it may be appropriate to use peer support programs as an adjunct to traditional therapeutic interventions such as counselling (e.g. Youth Focus Peer Support Camps).

Project design

There can be a number of issues in designing peer-based programs which can present challenges including unclear aims and objectives, choosing inappropriate design and setting, limited evaluation and a lack of clarity around program and individual boundaries.

There can be a lack of clarity around boundaries

The process of negotiating personal and professional boundaries is challenging, and even more so for young people who may not have experienced situations in which to practise skills to define and develop their professional conduct especially when working with their peers, many of whom may be friends.^2-5

Balancing peer participation

Striking a balance between developing youth empowerment and project control is difficult to achieve. Young people should feel they have a level of ownership in programs, however there still may be the need for adult involvement. It is determining the level of participation that can create challenges.

Research, theory and definitions for peer-based programs is inconsistent

There are a number of challenges in identifying the best way in which to achieve a good fit between available theories and models and the health issue.⁶ There is a lack of consistency in the research with regard to the theory that underpins peer-based programs as well as the definitions used in the delivery of peer-based programs.

Level of investment in peer-based programs

Whilst peer-based programs can be cost effective they should never be considered a cheap way to implement programs. Programs still require a high level of investment in personnel, planning, finance, research and time.

References

Visser, MJ 2004, Implementing Peer Support in Schools: Using a Theoretical Framework in Action Research. Journal of Community & Applied Social Psychology, 14(6): 436-454.
Turner, G 1999, ‘Peer support and young people’s health’, Journal of Adolescence, vol. 22, no. 4, pp. 567-72.
Milburn, K 1995, A critical review of peer education with young people with special reference to sexual health. Health Education Research, 10: 407-20.
Shiner, M 1999, Defining Peer Education. Journal of Adolescence, 22: 555-566.
Walker, S & Avis, M 1999, Common reasons why peer education fails. Journal of Adolescence. 22(4): 573-577.
McDonald, D 2004, ‘Alcohol and Other Drug Peer Education in Schools: A review for the ACT Alcohol, Tobacco and Other Drug Strategy Implementation and Evaluation Group’, Social Research and Evaluation, Canberra.

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